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Overview

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Overview

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  1. Telemedicine Cost and Clinical Efficiency Issues – Experience from a Pilot Project Between the Rikshospitalet- Radiumhospitalet HF (RR) Oslo, Norway and Methodist Rural Public Care Center (MPCH) Mursan IndiaVinod Mishra, PhDRikshospitalet-Radiumhospitalet University Hospital, Oslo, NorwayTTeC2006 conference2006 Tromsø

  2. Overview • Brief Norway and India equity and diversity • Goal telemedicine / telediagnostic project • Experience • Patient • Clinical efficiency • Cost efficiency • Barriers • Conclusion

  3. Population 4,604,800 • Life expectancy Male 76 year Female 82 year • GDP per capita 32 224 USD • Unemployment rate 4.4% • Health expenditures Health & social services 30 billion USD, 10.4 % of GNP • Hospitals expenses11 billion USD 1 USD = 6.50 NOK

  4. Population 1. 025 billion • Life expectancy Male 63.9 year Female 65 year • GDP per capita 3 400 USD • Unemployment rate 9.9 % est • Health expenditures Health & social services 5.3 % of total budget, 0.9 % of GNP • 60 millions mobiles telephone in 2005 (increasing 100% each year) • 12 millions new TV each year • 1.6 million new cars each year

  5. Telemedicine

  6. Telemedicine

  7. Main goals Web based Telemedicine project MURSAN • Provide expert opinion for under privileged patients • Facilitate medical consultation • Educational activities • Introduction of two-ways, interactive telecommunication between university hospital and primary health center

  8. Web based Telemedicine project - MURSAN • Image management and secure storage system • Future plan for real time tele-communication and education sessions • Web based system an economic mode of providing expert services to the primary center at remote site in India • Better management of patients since this system allows fast diagnosis, fast opinion and inter-consultation among specialist located not only at our hospital but around the world.

  9. Web based Telemedicine project – MURSAN Patients • Better access to care • Access to a multidisciplinary network of skills and competences • More relevant indication of patients- reduce transfers between primary- secondary and tertiary care • Societal benefits improved cost-effectiveness of treatment

  10. Web based Telemedicine project – MURSAN Clinical efficiency • Keep more patients to local providers • Major assets in favor of a network-organized professional practice • Professionals feel less lonely they are fellow worker • Ongoing learning and daily practice are interrelated • Effects on patient management- changes in clinicians decisions making

  11. Web based Telemedicine project – MURSAN Cost efficiency • Cost effective (direct cost, direct non medical cost and indirect cost, opportunity cost) • Cost of consultation a major issue • Patient non-emergent transport expenses • Standard hospitalization cost • Standard ancillary cost • Cost of specialists can be shared by low incidence users • Time reduction in work flow • Automatic and intelligent solution • Cost effective only if a certain threshold is achieved

  12. Web based Telemedicine project – MURSANbarriers • No institutional strategic plan for telemedicine • The technology is not as affordable as we think it is • The technology is not so easy to employ as we would like to believe • The technology is not as universally useful as we want • The infrastructure is not as ubiquitous as it needs to be • Clinicians are reluctant to use

  13. Conclusion • Web based telemedicine- telediagnostic is a win win situation for partners • Systems can be used as a tool for distance learning program between tertiary Sand primary level • Web based telemedicine- telediagnostic is JUST A TOOL • Experience shows that one must have • focus on clinical efficiency • focus on cost efficiency • use of cost-benefit analysis

  14. Telemedicine

  15. Norway Thank you for attention India

  16. Vinod Mishra Special advisor Rikshospitalet- Radiumhospitalet University Hospital Oslo Norway Tl. + 47 23 07 11 76 Fax + 47 23 07 11 78 Email: vinod.mishra@rikshospitalet.no www.rikshospitalet.no

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